| NPI | 1831202019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA14958) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0002910) |
| 363AS0400X Physician Assistant, Surgical (Licence: MD C0002910) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA14958) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2018-04-17 |